I would rather be a little overweight and not smoking...

I would rather be a little overweight and not smoking...

Lead

[-]

Mar 3 01 8:35 PM

Tags : None

Joel's Reinforcement Library

"I would rather be a little
overweightand not smoking
than underweightand dead."

This thought provoking sentiment was one panelist's opinion of the 10 pounds she gained when giving up cigarettes. While it
is not inevitable, many people do gain weight when quitting smoking. The reason is quite easy to explain - they eat more.

People eat more when quitting smoking for a variety of reasons. Food is often enjoyed more since the improved senses in
ex-smokers make it smell and taste better. For some, cigarettes decrease the appetite. Others use cigarettes as their cue that the meal has ended. Take
away the cigarette and they don't know it is time to stop eating. Social situations with food used to be easy as a smoker. When a smoker is done with
their food, they can sit and smoke while conversing with others at the table. Without cigarettes, they feel awkward just sitting, so they often order
extra coffee and dessert to last the duration of the conversation. All of these different behaviors add up to one result, extra calories eaten which
result in gaining weight.

Weight gain can be extremely dangerous to an ex-smoker. But this is not because of the strain on the heart. An average
ex-smoker would have to gain 75 to 100 pounds to put a strain on their heart equal to the extra risk associated with smoking a pack a day. And then, the
extra weight would not cause the lung destruction, cancer risk and many other conditions caused by smoking. The real danger of the extra weight is that
many ex-smokers use it as an excuse to go back to smoking. They think that if they smoke again they will automatically lose weight. To their unpleasant
surprise, many return to smoking and keep on the added pounds.

One clinic participant told how after three months without smoking she gained 15 pounds. Her doctor told her that she must lose
the weight. He said that if she had to, just smoke one or two cigarettes a day to help. If her doctor understood the addictive potential of cigarettes he
would never have given her such advice. For, as soon as she took her first few cigarettes, she started smoking in excess of 3 packs per day. Her weight
gain did not go away. When her doctor realized that she had returned to smoking, he warned her that it was imperative that she quit. In her condition
smoking was extremely dangerous. So not only did she still have to lose 15 pounds, but once again she had to go through the withdrawal process of stopping
smoking.

Smokers, ex-smokers or never-smokers can all lose weight the same way. The three ways to lose weight are to decrease the amount
of calories one eats, increase ones activities to burn extra calories, or, a combination of both techniques. While dieting may be more difficult for some
after smoking cessation, it is possible, and in many ways ex-smokers have major advantages over smokers for controlling their weight.

The most obvious advantage is that not smoking allows a person to do more physical activities, burning off fat in the process.
When smoking, exercise is tiresome, painful and for some, impossible. But with the improvement in breathing and cardiovascular fitness accompanying
smoking cessation, exercise can become a regular routine in the ex-smokers lifestyle. And while dieting may be difficult at first, ex-smokers should
realize that if they had the capability of breaking free from cigarettes, they could also decrease the amount they eat. It is simply a matter of using the
same determination initially used to quit smoking.

So, the next time you look in the mirror or step on a scale and feel that you are unhappy with your weight, start taking some
sensible steps to deal with it. Become active, eat lower calorie, nutritious foods, and pat yourself on the back for once again taking control of your
life. Not only will you lose weight, look and feel better, but you would have done it all without smoking. With that knowledge you should be extra proud.
If your weight has become a concern for you, diet, exercise and - NEVER TAKE ANOTHER PUFF!

I thought Jimy would appreciate this one. Yes both weight control and smoking cessation
can be accomplished simultaneously. While most choose not to do both at once, the ones who do seldom regret the
decision.

In short, its a matter of addictions. I have tried to make "not smoking" more of an addiction
than smoking was. The same with exercising and dieting. Finding my positive motivators was key.

It is all so clear today; my most difficult struggle presently is the fact that I'm 53
years old and I could have felt like this for the past 33 years. I just couldn't see or feel. I was controlled by nicotine. I was
OUT -out of shape, out of breath, out of cash, out of control,

I realize I can only move forward from here, and I intend to do so with vigor and enthusiasm. But for you younger
smokers, think about what you will lose if you continue your nicotine death march. I will always wonder what might have been.

I am older than all of you....58...gained 30 pounds the first
six months of my quit...In July, I said...that's it, no more and took charge of my eating and watched everything I put in my mouth.
Two months later, am down 15 pounds, do not smoke, and am starting to really feel good about myself and even
prouder.

People are shocked when they find out how old I am and that I
have four grandkids and I am not only grateful for that...I also am finally able to breathe easier too. It is all starting to fall into
place.

Take heartall of you and know that it takes a longer time for us "older folks" bodies to adjust to being deprived
of the nicotine that has been feed them them all these years. Take heart in knowing that a cardiologist said that our bodies do return to
the metabolic state they were in when smoking.....just takes about 6-9 months. Have talked to so many ex-smokers that are customers of
mine that have said the same thing....the weight WILL come off....just be patient and watch the calories.

When the weight does start to come off...you will feel just as
Joel says....proud to be smoke free and proud to be thinner. Just don't give up on either...remember, I am older and it has taken me
longer...but I am doing it and so will you.

Thanks Joel !! Linda!! I told you you look mahvelous!! After 6 months + I now feel secure
enough without those killers to concentrate on my weight. I think I have about 10 lbs. extra - I didn't care until I tried on my fall
wardrobe - oops. Now I can concentrate on some excersize!!

I was so proud of myself I did not gain a single gram since I was 25, but recently I asked
myself: So what? I am skinny, but my lungs capacity were diagnosed as 118 years old person. I couldn't do any excersize without getting
extremally tired, and now I'm able to walk 10 miles. I gained 4 kilograms since I quit, but....

Quit smoking was a first step, maintain a decent weight will be a next
one.

A little overweight is indeed better than being a junkie! I am watching what I eat and I am exercising. In spite of all that
hard work, I have gained weight. I remain MOTIVATED though because if I can gain the incredible
control it takes to remain smoke free, I can certainly take control of my weight and physical fitness. It may take some time but so did quitting
smoking. Right now I feel it is important to concentrate on my quit - that gets better each day and as it does, I focus more and more on fitness and
nutrition. If anyone is getting frustrated out there about weight gain - Never Take Another Puff! Focus on the Quit, Exercise, Eat the Good Stuff, and stay
motivated. With those improving lungs you will be able to burn more fat than ever before - just give yourself andkeep up that spirit!

Breathing Easier

1 Month, 1 Week, 5 Days, 10 pounds heavier but getting so much healthier and smelling so much better and running so much faster
and smiling so much brighter!

I am attaching an article below from the New York Times from last month
discussing the potential problems with the exaggeration of the number of deaths being attributed to obesity from some recent
reports in the United States. I want to be careful as to how to approach this topic. The purposed of our board is to primarily
focus on smoking cessation issues. We have very strictly enforced guidelines on now allowing debates or discussions that can
easily divert readers attention from smoking issues, and this issue can take on a life of its own if we are not careful. I am
just going to discuss how these reports may have affected the way some people thought about smoking and to try to make it clear
on how important not smoking is for reducing people's risks of premature death.

Over the past few months that has been a lot of attention given to the
issue of the dangers of obesity soon becoming the number one cause of preventable death in the United States, possibly
overtaking smoking which now carries that dubious distinction. If smoking were to one day fall to the number two position, it
should by no means fall off the radar string of public health concerns--it would still be killing well over 400,000 Americans a
year and not a single one of these victims' family members or friends would take any solace that at least the person did
not die from the #1 killer.

My concern with these reports though was that it was very likely leading
some smokers to conclude that they should not quit smoking because they would gain weight and that weight would result in a
greater risk of death than smoking. No matter where the overall numbers end up being of how many people die from obesity, it
doesn't change the fact that from what we know now that a person would have to gain over 75 pounds to increase the workload
on the heart and elevate the risk of premature death to levels experienced by smokers.

The original projection being raised was that obesity deaths were going to
overtake smoking deaths in the next year or two. It was found though that the projections were based on a math error performed
in the statistical calculation in the CDC published reports--resulting in an overestimation of about 80,000 deaths, or about a
20 percent exaggeration of the number of deaths. There are a few other issues being raised by some scientists that there are
other flaws in how the numbers were calculated which may very well result in the numbers of deaths attributed to obesity being
overestimated. Unless smoking rates drop dramatically it is likely that smoking is going to still carry the dubious distinction
of being the number one cause of preventable deaths for many years to come.

Besides my concern that some people will underestimate the risks of
smoking, my other concern is that some people will think that if obesity studies were impacted by a math error, that smoking
numbers are also grossly exaggerated by similar errors happening every now and then. People need to know that the dangers of
smoking have been studied critically for decades now. Not just by one government agency in one country, but by lots of official
agencies from governments all over the world, and most public health and most of the voluntary professional health
organizations too and have consistently been shown to be a major cause of preventable deaths throughout the world for decades
now. The way to reduce your own personal risk of becoming one of these smoking statistics is to simply continue to stick with
your commitment to never take another puff!

Joel

Article from the November 24, 2004 New York Times

Data on Deaths From Obesity Is Inflated, U.S. Agency
Says
By GINA KOLATA

Published: November 24, 2004

The Centers for Disease Control and Prevention says that its widely publicized estimate that 400,000 Americans die each year
from being too fat is wrong and that it will submit a new, lower figure to the medical journal that published its original
estimate last March.

It will be a simple correction of an inadvertent calculation error, the centers said.

But that figure of 400,000 deaths has taken on a life of its own. Those concerned about obesity cite it to show that being
fat is almost as bad as smoking. And tobacco opponents attack the number, saying it is grossly, possibly purposely,
inflated.

Yesterday, The Wall Street Journal reported that the centers planned to revise the estimate and had undertaken an internal
review of the study, published in The Journal of the American Medical Association.

The estimate originated with an effort by the C.D.C. to determine the effects of the nation's growing number of
overweight and obese people.

The result was a paper by Dr. Ali H. Mokdad and colleagues published in the medical journal that was controversial from the
start, with some of the most vigorous attacks coming from antitobacco groups.

But beneath the dispute lies a truth about science and its uses in an age of limited resources.

If obesity is a leading cause of death, more money should be spent to try to prevent it, and to treat it. Insurers should
pay for diet programs or weight-loss surgery. If it is not so deadly, some fear, the impetus to pay for such things might
vanish.

On the other hand, the more money that goes to fighting obesity, the less will be available for other programs, like
antitobacco ones.

"The tobacco people are afraid that it's a zero sum game," said Dr. Eric Oliver, a political scientist at the
University of Chicago who is writing a book in the politics of obesity. "If obesity gets declared Public Enemy No. 1,
it's going to come at their expense."

Now, with disputes and reviews under way, it is by no means certain what the final, official consensus on obesity deaths
will turn out to be. The correction to the original article may be just the beginning as the agency has now asked for outside
advice on how to do the calculations.

In response, said Dr. Dixie Snider, the chief scientist at the centers, the Institute of Medicine will have a meeting next
month to discuss the appropriate statistical methodology to calculate obesity deaths. "One of the things we're trying
to do is not to come up with any one person's favorite method," Dr. Snider said.

But Dr. Snider insisted that the paper in question was actually of only minor importance in the nation's fight against
fat.

"We regret that we published a number that in retrospect was incorrect," Dr. Snider said. "And we regret the
confusion. But the underlying message does not change. The paper makes clear and the erratum makes clear that tobacco and
obesity are the two biggest killers."

Others disagreed, often forcefully.

"The kind of policies one would develop for something that is killing about as many people as tobacco or a quarter as
many people as tobacco are very different," said Dr. Stanton A. Glantz, professor of medicine and director of the Center
for Tobacco Control Research and Education at the University of California, San Francisco.

Dr. Glantz estimates that the number of deaths from obesity to be more like 100,000 than 400,000. And the inflated numbers
of obesity deaths, he added, represent " a very, very fundamental mistake that was made in the paper, which they have done
nothing to address."

"This is not some esoteric little detail over which there is huge uncertainty," he said.

Others, who are not part of the antitobacco movement, agreed with Dr. Glantz that the 400,000 figure made little sense.

Dr. Oliver, for example, said obesity, like tobacco, had little effect on mortality in people over 65. So with two million
deaths a year in the United States, 70 percent of which are among people over 65, virtually every younger person who dies would
have to die from obesity. "The numbers simply don't add up," he said.

That is the same argument made by two statisticians at the disease control agency, Dr. David Williamson and Dr. Katherine
Flegal, who published papers this year reporting that the statistics used to calculate the obesity deaths were wrong.

They noted that the way to estimate deaths from obesity was to look at each age group and ask how many deaths might be due
to obesity and then add the numbers to get the total deaths. That is the way the agency calculated tobacco deaths, coming up
with a figure of 435,000. But for obesity, the agency looked at the death risk in younger people and extrapolated it to the
entire population.

In response to the obesity analysis, the Office on Smoking and Tobacco at the centers circulated its own analysis of tobacco
deaths. Using the same methodology as had been used for obesity, it came up with about 640,000 deaths from tobacco.

Dr. Snider says he knows about that tobacco office analysis and is aware of that criticism of the mortality estimates. But,
he said, he does not think that is the entire answer to getting the statistics right, and he is counting on the Institute of
Medicine Review to provide guidance.

But that institute is not going to satisfy someone like Dr. Glantz.

Antitobacco advocates are furious, he said, and he hears from them regularly. But others, too, are outraged, Dr. Glantz
said. When he mentioned his criticisms of the centers' statistics at a National Cancer Institute meeting on tobacco
control, he said, "it was like turning on a spigot."

It is better to be a fat ex-smoker than a thin smoker: findings from the 1997–2004 National Health Interview Survey−National Death Index linkage study

Objective The aim of this research was to compare the risk of all-cause mortality and mortality from all cancers combined, lung cancer, respiratory diseases, cardiovascular diseases and diabetes mellitus between normal-weight smokers and overweight or obese ex-smokers.

Methods Data were from 1997 to 2004 National Health Interview Survey (with response rates ranging from 70% to 80%) which were linked to records in the National Death Index. Mortality follow-up was through 31 December 2006. The sample was limited to normal-weight smokers and overweight/obese ex-smokers 25 years of age and older (n=52 819). HR from Cox regression was computed to represent mortality effect.

Results Results showed that in both women and men, normal-weight smokers, relative to overweight or obese ex-smokers, had a higher risk of mortality from all causes combined, all cancers combined, lung cancer, cardiovascular and respiratory diseases. Among women, there was no difference in mortality risk from diabetes mellitus between normal-weight smokers and overweight or obese ex-smokers. Among men, there was some evidence that the risk of mortality was higher in obese ex-smokers than normal-weight smokers.

Note here: I usually wait for John to find and post these kind of studies but the title of this one just jumped out at me that it needed to be attached to this string. I wish I remembered and still had contact with the clinic panelist who first said "I would rather be a little overweight and not smoking than underweight and dead." I originally wrote the article in 1984.